title: Flat epithelial atypia: comparison between 9-gauge and 11-gauge devices.
abstract: BACKGROUND
  This study aimed to establish if women with a diagnosis of flat epithelial atypia (FEA) without residual microcalcifications at stereotactic vacuum-assisted breast biopsy (VABB) could be managed with mammographic follow-up (FU) instead of surgery and to compare 9-gauge and 11-gauge devices.
  
  
  METHODS
  From October 2003 to January 2011, 2382 VABB procedures were performed (1373 with 11-gauge and 1009 with 9-gauge). We found 121 cases of pure FEA that were surgically treated: 57 with a 9-gauge device (group 1) and 64 with an 11-gauge device (group 2). The underestimation rate (UR) of malignancy for patients without and those with residual microcalcifications for each VABB device was calculated. Differences between groups were analyzed with the Fischer exact test.
  
  
  RESULTS
  The overall UR of FEA was 4% (2 of 57) with the 9-gauge device and 8% (5 of 64) with the 11-gauge device. With a 9-gauge device, the UR for patients without residual microcalcifications was 0% (0 of 46), and the UR for patients with residual microcalcifications was 18% (2 of 11). With an 11-gauge device, the UR for patients without residual microcalcifications was 0% (0 of 39), the UR for patients with residual microcalcifications at post-biopsy mammograms was 16% (5 of 25). With a 9-gauge device, 80% (46 of 57) of patients did not have residual microcalcifications after VABB. With an 11-gauge device, 60% (39 of 64) of patients had no residual microcalcifications after VABB. Differences between the 9-gauge and 11-gauge devices were statistically significant (P < .05).
  
  
  CONCLUSIONS
  Women with FEA without residual microcalcifications after VABB can be managed conservatively. Nine-gauge VABB is associated with a lower percentage of residual microcalcifications compared with an 11-gauge device, but it is safe to follow patients with FEA if all calcifications are removed with the core biopsy.
authors.affiliation: Department of Radiology, "San Bartolomeo di Sarzana," Sarzana, La Spezia, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Villa
authors.forename: Fabio
authors.initials: F
authors.lastname: Chiesa
authors.forename: Tiberio
authors.initials: T
authors.lastname: Massa
authors.forename: Daniele
authors.initials: D
authors.lastname: Friedman
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Canavese
authors.forename: Paola
authors.initials: P
authors.lastname: Baccini
authors.forename: Massimo
authors.initials: M
authors.lastname: Calabrese
authors.forename: Alberto
authors.initials: A
authors.lastname: Tagliafico
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002114:Calcinosis / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D061705:Image-Guided Biopsy; D008327:Mammography; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D014618:Vacuum
keywords: Breast cancer; Flat epithelial Atypia; Underestimation rate; vacuum-assisted breast biopsy